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Asbestos Diseases May Claim More than 10 Million Lives, International Ban Needed

Monday, August 9th, 2010

By Wade Rawlins

All asbestos causes malignant mesothelioma and other forms of cancer. Yet even today, a large number of countries continue to import and export asbestos and use asbestos products. A ban is urgently needed on all forms of asbestos, according to an international academic society that analyzes critical occupational and environmental health issues.

In a new article in the journal Environmental Health Perspectives, 16 occupational health researchers from the U.S., Great Britain, Japan, Italy, Canada, India and South Africa —representing the Collegium Ramazzini — write that the profound tragedy is that all illnesses and deaths related to asbestos are preventable. Yet the incidence of asbestos disease increases. The researchers say the risks of asbestos exposure cannot be controlled by technology or by workplace practices. They call for a worldwide ban on the mining and manufacture of all forms of asbestos.

Decades after asbestos was declared a human carcinogen, about 125 million people around the world remain exposed to asbestos at their workplaces, according to the World Health Organization. An estimated 43,000 people died of mesothelioma in 2000 and a much larger number of lung cancer deaths were due to workplace exposure to asbestos. In the U.S., about 2,500 to 3,000 people die of mesothelioma each year and thousands more from lung cancer. Asbestos diseases may claim as many as 10 million people before asbestos is banned worldwide and all exposure is halted, the researchers say.

Despite industry claims to the contrary, all forms of asbestos cause asbestosis, a progressive lung disease as well as mesothelioma, lung cancer and cancer of the larynx. Mesothelioma is an incurable cancer of the lining of the lung or abdomen closely linked to asbestos-exposure. Typically, people who inhale asbestos fibers do not notice any symptoms of disease for 30 years or longer after exposure.

Fifty-two countries, including all members of the European Union, now ban all forms of asbestos. Yet many countries including the United States still import asbestos and make and use asbestos products. A number of countries that ban some forms of asbestos make an exception for chrysotile asbestos, which accounts for nearly 100 percent of the asbestos mined today and about 95 percent of the asbestos ever mined.

The asbestos industry claims that asbestos-related cancers are caused by forms of mineral fiber other than chrysotile asbestos and that chrysotile poses less risk to workers. But scientists and physicians generally agree that chrysotile causes various cancers including mesothelioma and lung cancer. Numerous studies refute industry reports that chrysotile is safe, according to the researchers.

Russia is now the leading producer of asbestos, followed by China, Kazakhstan, Brazil, Canada, Zimbabwe and Colombia. Most asbestos production occurs in Eastern Europe and Asia, often with little or no protection of workers or surrounding communities. Asbestos cement accounts for more than 85 percent of worldwide production.

“Scientists, physicians and responsible authorities in countries allowing the use of asbestos should have no ‘illusion’ that controlled use of chrysotile asbestos is an effective alternative to a ban on all use of asbestos,” the researchers say.

Labels: Asbestos, Mesothelioma
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Guidelines for Mesothelioma Treatment

Monday, July 26th, 2010

The incidence of malignant mesothelioma, a respiratory cancer associated with inhaling asbestos, is expected to double in many countries in the next 20 years, according to the European Society of Medical Oncology. In the United States, approximately 2,500 to 3,000 people die of mesothelioma each year.

In an article in the July issue of the Annals of Oncology, the European Society of Medical Oncology outlines treatment guidelines for patients with mesothelioma. The clinical practice guidelines are developed by the non-profit professional organization, which promotes advances in cancer treatment and prevention, to assist doctors and patients in making decisions about appropriate health care. According to the practice guidelines:

Patients with mesothelioma often first have symptoms of shortness of breath due to excess fluid in the chest. Patients with more advanced cases may have chest pain. A chest x-ray or scan may suggest a case of mesothelioma based on thickening of the membrane lining the the lung called the pleura. Laboratory examination of chest fluid can confirm a diagnosis of mestohelioma. But the lab reports are often equivocal.

Doctors should interview the patient about their work history to try to determine if they were exposed to asbestos in their workplace, the most common cause of mesothelioma. Most cases of mesothelioma are due to occupational exposure

The gold standard for diagnosis of mesothelioma is a microscopic examination of specific antigens in a tissue biopsy obtained through a surgical procedure called a pleuroscopy. A surgical instrument is inserted into the patient’s chest through an incision to collect tissue. Research studies suggest that certain proteins and oseteopontin, a human gene product, are useful indicators to support a diagnosis of methothelioma.

After doctors confirm a diagnosis, a CT scan of the patient’s chest is used to assess the advancement of the cancer. An accurate asessment of the mesothelioma’s stage is essential to determine the most appropriate treatment and the patient’s prognosis. Malignant pleural mesothelioma rarely spreads to distant parts of the body, but patients often have advanced localized cancer in their respiratory system when they are diagnosed.

Various surgical procedures have been used with varying degrees of success, according to the European Society of Medical Oncology. Surgery should be performed only on patients with less advanced cases of mesothelioma as part of a multi-pronged approach to treatment combined with chemotherapy and/or radiation. The use of radiation in treating mesothelioma has been limited because of the difficulty of irradiating such a large area of the body as a lung without irreparably harming the adjacent healthly lung. Still, it is used.

As far as chemotherapy, the use of combinations of cancer drugs, permetrexed and cisplatin, and to a lesser extent, raltitrexed and cisplatin, have led to improved survival results in patients as well as lung function and symptom control, compared to use of cisplatin in clinical trials. The combination of permetrexed and carboplatin is an effective alternative chemotherapy.

Labels: International News, Mesothelioma, Patients, Treatments, Uncategorized
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Ten-Fold Increase in Mesothelioma Deaths in Great Britain

Thursday, July 22nd, 2010

Deaths from mesothelioma, a respiratory cancer associated with asbestos exposure, have increased more than ten-fold in Great Britain over 40 years.

A study in the July issue of the British Journal of Cancer noted that mesothelioma deaths now represented more than 1 percent of all cancer deaths in Great Britain. Mesothelioma develops in the lining of the lungs or abdomen, typically 30 years or longer after workers inhale asbestos fibers.

The researchers predict that mesothelioma will claim the lives of 91,000 people in Great Britain between 1968 and 2050, with about 61,000 of those deaths occurring after 2007.

While mesothelioma can strike anyone, about 85 percent of victims of mesothelioma in Great Britain are males, many of whom worked in trades where asbestos use was common such as plumbing, ship building, construction and sheet metal work. Asbestos is now banned in Great Britain, but was widely used in building materials until recent decades. The peak year of asbestos exposure was 1963, the study said.

The researchers predicted that mesothelioma mortality among males would peak in the year 2016 with more than 2,000 deaths annually, then decline.

The annual number of mesothelioma deaths in Great Britain has risen fairly steadily from 153 in 1968 to 1848 in 2001, according to the British Health and Safety Executive. Because of the long latency period, many of the recent mesothelioma deaths are a result of heavy asbestos exposure in earlier decades. Britain’s mesothelioma register recorded the deaths of more than 1,700 men in 2006, according to the article.

Labels: International News, Mesothelioma, News
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Response of Mesothelioma Patients’ Tumors to Chemotherapy May Offer Clues

Thursday, July 8th, 2010

Researchers at Columbia University report that changes in the size of tumors in patients with pleural mesothelioma who have undergone chemotherapy may be useful in predicting their response to treatment and survival. Pleural Mesothelioma is an incurable cancer of the lining of the lung associated with exposure to asbestos.

Thousands of Americans have been exposed to asbestos in building materials and manufacturing, and 2,000 to 3,000 die each year of mesothelioma. Typically, 30 to 40 years elapse between the asbestos exposure and the onset of cancer symptoms. Doctors often don’t diagnose the disease until it has reached an advanced stage. The median survival is a year to 18 months.

In a new article in the Journal of Thoracic Oncology, researchers at Columbia’s Memorial Sloan-Kettering Cancer Center describe the outcomes of clinical trials involving 30 mesothelioma patients who were treated with chemotherapy followed by surgery and radiation.

The researchers took CT scans of the 30 patients’ lungs and calculated the size of their tumors before and after two rounds of chemotherapy. Patients diagnosed with stage III and stage IV cancer generally had larger tumors than those with less advanced cancer. The percentage change in the size of the tumor from the initial measurement to their evaluation after two cycles of chemotherapy was strongly associated with patients’ overall survival, the researchers said. They found a significant difference in the length of survival among patients whose tumors increased after chemotherapy and those whose tumors decreased.

The researchers said computer-aided measurements of tumors may offer doctors a more reliable way to assess patients’ response to treatment and could provide additional information about patients’ prognosis.

Labels: Mesothelioma, Research
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Researchers Report Clearer Understanding of How Asbestos Causes Mesothelioma

Tuesday, July 6th, 2010

The paradox of how asbestos kills cells and yet spurs growth of cancerous tumors has perplexed scientists for decades. A group of scientists led by researchers at the University of Hawaii claim to have new insights into the process. Their research may offer new tools to identify people at risk of developing mesothelioma and to prevent or slow tumor growth in people already diagnosed with asbestos-related disease.

Thousands of Americans have been exposed to asbestos and are at risk of developing malignant mesothelioma, a cancer of the lining of the lung or abdomen. Approximately 2,000 to 3,000 people die of mesothelioma each year in the United States and tens of thousands more worldwide. In addition, asbestos exposure raises the risks that smokers will develop lung cancer.

But the long latency period of 30 to 50 years from asbestos exposure to the appearance of tumors may offer a window of opportunity to block the trigger mechanism that causes asbestos-related cancer.

People often unknowingly inhale microscopic asbestos fibers at workplaces and the fibers can permanently lodge in the lung, causing inflammation. Most human cells exposed to asbestos die within 24 to 48 hours. Dead cells should not be able to multiply and form tumors. So how do cancerous tumors eventually form?

In an article in the Proceedings of the National Academy of Sciences, the researchers describe how asbestos kills cells through a process called programmed cell necrosis that leads to the release of a molecule called mobility group box 1 protein or HMGB1. The protein begins an inflammatory chain reaction in tissue that causes the release of mutagens that promote tumor growth. Cancer often occurs in the presence of chronic inflammation.

Asbestos exposure leads to elevated levels of HMGB1 in the blood, the researchers note. In the study, people with a history of asbestos exposure had HMGB1 levels that were more than four times higher than those of healthy people who had not been exposed.

The researchers say that mesothelial cell death and release of HMGB1 function as triggers in mechanism that leads to asbestos-related cancers. Based on that, they suggest it may be possible eventually to target HMGB1 to treat mesothelioma and identify groups of people who have been exposed to asbestos by simple blood tests to measure HMGB1 levels. By interfering with the inflammatory reaction prompted by asbestos, it may be possible to decrease the occurrence of mesothelioma and reduce the rate of tumor growth among people already diagnosed with mesothelioma.

In the future, therapeutic approaches aimed at blocking chronic inflammation and in particular the protein HMGB1 could reduce the risk of malignant mesothelioma among workers exposed to asbestos.

To test their theory, the lead researchers, Drs. Haining Yang and Michele Carbone of the University of Hawaii plan to conduct a clinical trial in Cappadocia, Turkey, where more than 50 percent of the population of two rural villages dies of mesothelioma from exposure to mineral fibers used in building materials. If the trial produces positive results, they plan to try a similar approach on groups of people exposed to asbestos in the U.S.

Labels: Cancer, Featured News, Mesothelioma, Research
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California Reconsiders State Symbol Associated with Chrysotile Asbestos

Thursday, June 24th, 2010

For more than 40 years, California’s official state rock has been serpentine, a greenish gray rock linked to the state’s gold rush.

But serpentine is a primary source of asbestos, a mineral fiber that causes serious respiratory disease in humans including mesothelioma, a cancer of the lining of the lungs or abdomen. Chrysotile asbestos, the most widely used commercial form of asbestos, comes from serpentine

Because asbestos is a human carcinogen and California has the highest rate of mesothelioma deaths in the nation, a California lawmaker has filed legislation to strip serpentine of its status as an official state symbol and make a statement of findings about the increased risk of mesothelioma associated with chrysotile asbestos.

The bill, introduced by Sen. Gloria Romero, a Los Angeles Democrat, says, “Serpentine contains the deadly mineral chrysotile asbestos, a known carcinogen… California should not designate a rock known to be toxic to the health of its residents as the state’s official rock.”

The California Assembly Natural Resources Committee on Wednesday approved the legislation, stripping serpentine of its official designation and sent the bill to the Assembly floor for consideration. An earlier version of Romero’s bill previously passed the California Senate.

Labels: Asbestos, Mesothelioma
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Mesothelioma Specialist Named Chief of Thoracic Surgery at Mount Sinai

Wednesday, June 9th, 2010

Renowned thoracic surgeon Raja M. Flores, M.D., who specializes in treating mesothellioma, lung cancer and esophageal cancer, has been named Chief of Thoracic Surgery at The Mount Sinai Medical Center and Director of the Thoracic Surgery Oncology Program at Mount Sinai Cancer Center, the Medical Center announced.

“Dr. Flores joins us at a propitious moment in the history of our cancer program,” Wayne Keathley, President and Chief Operating Officer of The Mount Sinai Hospital said in a press release. “We are emerging as a clear leader in caring for patients facing mesothelioma and cancers of the esophagus or lung.”

Mesothelioma is an aggressive cancer of the lining of the lung or abdomen linked to asbestos exposure. While use of asbestos has been curbed in the United States since the late 1970s, the incidence of mesothelioma has been increasing in the United States and worldwide in recent decades. The disease strikes 30 to 50 years after exposure to asbestos.

Dennis S. Charney, M.D., and Dean of Mount Sinai School of Medicine and Executive Vice President for Academic Affairs of The Mount Sinai Medical Center, said Dr. Flores had conducted a landmark study that changed the surgical treatment of pleural mesothelioma. The study, entitled “Extrapleural Pneumonectomy versus Pleurectomy Decortication in the Management of Malignant Pleural Mesothelioma,” has been one of the most frequently cited studies from the Journal of Thoracic and Cardiovascular Surgery for the last two years.

Dr. Flores helped pioneer the use of intraoperative chemotherapy for treatment of mesothelioma. The procedure involves bathing the abdominal cavity or chest cavity in a heated chemotherapy solution after removal of cancerous tumors. Heating the fluid increases the penetration of the drugs into the tissue.

Flores has co-authored more than 150 peer-reviewed manuscripts, reviews, books and book chapters and presented more than 100 lectures. His work has been published in many journals including The Journal of Clinical Oncology, Journal of Thoracic Oncology, The Annals of Surgery, The Annals of Thoracic Surgery and Vascular Surgery and other publications.

David H. Adams, M.D., chairman of the Department of Cardiothoracic Surgery at The Mount Sinai Medical Center described Dr. Flores as “a technically superb surgeon.”

“He also made efforts towards improving treatments for mesothelioma through the compilation of a database of over 1,000 patients in order to research areas of failure,” Adams said.

During the past decade, Dr. Flores has held posts at Memorial Sloan-Kettering Cancer Center, mostly recently as Associate Professor of Cardiothoracic Surgery. He is a graduate of New York University and the Albert Einstein College of Medicine, receiving his M.D. in 1992.

Dr. Flores’s appointment becomes effective Aug. 1.

Labels: Asbestos, Mesothelioma, Research, Uncategorized
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Clinical Trial of Experimental Mesothelioma Drug Promising

Thursday, April 22nd, 2010

Researchers announced positive results from tests of an experimental anti-cancer drug known as NGR-hTNF in controlling the cancer of patients with malignant pleural mesothelioma. Mesothelioma is an incurable cancer of the lining of the lung associated with asbestos exposure.

NGR-hTNF is a novel drug compound that includes a peptide—a chain of amino acids—that homes in on cancer cells—and a type of protein known as tumor necrosis factor that helps regulate the immune system response to cancerous tumors. Developed by an Italian pharmaceutical company, MolMed S.p.A., the drug is designed to better permeate cancerous tumors and act directly on blood vessels that feed a tumor’s growth.

In an article published this week in the Journal of Clinical Oncology, Italian researchers said NGR-hTNF was given to 57 mesothelioma patients either every three weeks or every week. The patients had previously undergone chemotherapy and had a relapse. The results showed the drug temporarily stopped the advance of the cancer in 26 patients for about five months on average. Median survival was 12 months.

The researchers said the disease control provided by NGR-hTNF and patients’ ability to tolerate the drug warranted further study with patients with advanced pleural mesothelioma.

The drug is being studied as an alternative treatment for patients whose cancer is not responding to the more standard chemotherapy regimen involving permetrexed. A phase III clinical study is underway. Researchers are exploring it use by itself or in combination with other medications.

On the basis of the latest results, the drug was granted orphan drug designation for treatment of malignant mesothelioma in the United State and in Europe, MolMed S.p.A., announced.

The federal Orphan Drug Act provides special status to drugs used to treat a rare disease or condition at the request of the drug sponsor. MolMed S.p.A., an Italian pharmaceutical company, is developing the drug. The orphan designation provides tax credits and government incentives to sponsors that bring develop drugs to treat rare diseases. About 2,000 to 3,000 people die of mesothelioma in the United States each year, but incidence of the disease has increased significantly in recent decades.

The drug must go through the Food and Drug Administration marketing approval process like any other drug. Orphan drugs often receive expedited review because they are for serious or life threatening diseases, according to the Food and Drug Administration.

Labels: Mesothelioma, Research
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Researchers Estimate Effect of Surgery to Extend Lives of Mesothelioma Patients

Thursday, April 8th, 2010

Researchers at the University College London sought to estimate whether patients with malignant mesothelioma who undergo surgery to remove a portion of the cancerous lining of the lung or abdomen survive longer than patients who receive other kinds of treatment. Mesothelioma is a cancer of the lining of the lung or abdomen closely associated with asbestos exposure.

Treatments typically available to patients diagnosed with malignant mesothelioma are surgery, chemotherapy and radiation or a combination of the three. This is known as multi-modality treatment, or more simply a multi-pronged assault on the cancer. To analyze the medical data, researchers divided the data on mesothelioma patients into four groups:

• Patients who did not have surgery;
• Patients who had their chest cavity opened surgically, but did not have organs removed;
• Patients who had tissue such as a lung and the lining of the lung removed, but did not undergo chemotherapy afterward;
• Patients who had organs and cancerous tumors removed as well as chemotherapy and/or radiation.

The researchers estimated the survival advantage of treatment approaches that included surgery at nine months at best. They said that was the most optimistic estimate, assuming that the difference in survival was entirely attributable to the treatment and not to the patient’s relative fitness to withstand surgery. They said this should be taken into consideration given the risks of surgery.

Patients who had surgery and chemotherapy or radiotherapy showed the best results, surviving about 32 months on average – or roughly twice as long as patients who had other types of treatments, researchers reported. The study was published in the European Journal of Cardiothoracic Surgery.

Labels: Mesothelioma, Research
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Study Explores Surgery and Combo of New Chemotherapy Drugs

Sunday, March 21st, 2010

Researchers at Brigham and Women’s Hospital in Boston have been recruiting patients with malignant mesothelioma for a study of the effectiveness of using a combination of chemotherapy drugs after removal of cancerous tumors.

Pleural Mesothelioma is a cancer of the lining of the lung and is closely linked to inhaling asbestos fibers. The symptoms of mesothelioma which is incurable, typically appear 30 to 50 years after exposure to asbestos.

Surgery remains the optimal procedure for reducing the presence of malignant mesothelioma tumors to the microscopic level. After removing visible tumors from a patient’s chest, doctors then use chemotherapy drugs to stop cancer cells from growing and spreading. Cisplatin currently is used as a drug in chemotherapy treatments.

The study, led by Dr. David Sugarbaker, a mesothelioma specialist, is exploring whether Cisplatin can be used safely in combination with another anti-cancer drug, gemcitabine to treat mesothelioma patients.

Gemcitbine, which is marketed as Gemzar, belongs to a family of drugs call antimetabolites that attack cells in the metabolic process. It prevents cells from making RNA and DNA, which stops cell growth. If cells stop dividing, they die, causing tumors to shrink. Gemcitabine has been used to treat pancreatic cancer, bladder cancer, ovarian soft-tissue sarcoma, breast cancer and non-small cell lung cancer.

As part of the study, the chest cavities of patients are bathed in the drugs for one hour after tumors are removed, and the drugs also will be warmed to a temperature of 107 degrees

Another recent study involving researchers at eight medical research universities in the U.S., Italy, France, Germany and Australia reported some success in extending the lives of patients suffering from malignant mesothelioma in the lining of the abdomen or peritoneal mesothelioma, by employing a combination of surgery and heated chemotherapy drugs.

The study, published in the Journal of Clinical Oncology, found that of 405 patients treated in the study, the overall median survival rate of the patients was 53 months, and 47 percent remained alive after five years. The high temperature of the chemotherapy solution has been found to increase its therapeutic effect. Both heat and direct contact with chemotherapy drugs kill cancer cells.

Labels: Mesothelioma, Research
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Wade Rawlins is a former environmental reporter with the Raleigh News & Observer.

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AboutMesothelioma.Net

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California Reconsiders State Symbol Associated with Chrysotile Asbestos

Mesothelioma Specialist Named Chief of Thoracic Surgery at Mount Sinai

Clinical Trial of Experimental Mesothelioma Drug Promising

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